Understanding the relationships between the physical environment and physical activity in older adults: a systematic review of qualitative studies

Background: While physical activity (PA) provides many physical, social, and mental health benefits for older adults, they are the least physically active age group. Ecological models highlight the importance of the physical environment in promoting PA. However, results of previous quantitative research revealed inconsistencies in environmental correlates of older adults' PA that may be explained by methodological issues. Qualitative studies can inform and complement quantitative research on environment-PA relationships by providing insight into how and why the environment influences participants' PA behaviors. The current study aimed to provide a systematic review of qualitative studies exploring the potential impact of the physical environment on older adults' PA behaviors.

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Methods: A systematic search was conducted in databases of various disciplines, including: health, architecture and urban planning, transportation, and interdisciplinary databases. From 3,047 articles identified in the initial search, 31 articles published from 1996 to 2012 met all inclusion criteria. An inductive content analysis was performed on the extracted findings to identify emerging environmental elements related to older adults' PA. The identified environmental elements were then grouped by study methodologies [indoor interviews (individual or focus groups) vs spatial methods (photo-voice, observations, walk-along interviews)].

Alex’s Notes: I have talked often about children and adolescents with regard to physical activity, but only 40% of those aged over 65 years of age met the recommended aerobic activity guidelines or strength training guidelines, with only 12% accomplishing both. For clarity, the government recommendations include 150 minutes of moderate or 75 minutes of vigorous aerobic activity per week in addition to two days per week of full-body strength training. Yes promoting the fitness of our future (children) is critical, but maintaining the youth of our past (elderly) is also vitally important. The review at hand illustrates the barriers and promoters of physical activity in older adults from an environmental standpoint.

It is clear from the above list that in order to promote elderly physical activity both in exercise facilities and outdoors, environments should provide high-quality pedestrian infrastructure, be safe from crime and traffic, provide easy access to exercise opportunities, daily destinations, and rest areas, be aesthetically appealing, and provide a pleasant nature-based experience. I believe these are traits we would all like to experience, so next time you are on a walk or in your garden, do something to make the place a little more pleasant. We will all win that way.